Carrier Conundrums KO or GOOD TO GO Surprising State Specifics Dastardly Declinable Drugs Miscellaneous Madness
100
What are Aetna companies (Accendo, Aetna, Puritan, SGIC, USIC, Capitol) and Cigna?
Carriers that do not ask about tobacco use.
100
What is a KO?
A client who says they are pre-diabetic and had a stroke 10 years ago.
100
What are CA, FL, ME, MN, OR, and WA?
In these states, UHC will decline a client instead of rating them up to level 2 for certain health conditions.
100
What is methotrexate and prednisone?
These are two common drugs used to treat Rheumatoid Arthritis, and are HKO with most carriers.
100
What is Mutual of Omaha?
This carrier is most lenient with blood thinners, commonly used to treat A-fib.
200
What is the Aetna family?
The only carrier that will accept a client with COPD.
200
What is Good to Go?
A client who had a procedure done for a carcinoma last week and has no follow ups
200
What are CT, ID, IL, OH, OK, RI
These states are 2 applicants always for household discounts.
200
What is Oxygen use and Nebulizer use?
These common treatments for COPD are declinable with all carriers.
200
What is Maryland?
This state requires a 7 year lookback on all health questions.
300
What is Cigna?
This company declines (or rates up, if applicable) for diabetes + tobacco use
300
What is Good To Go?
A client who has to use a cane when out and about, like at the grocery store, or when she takes her grand kids to the zoo.
300
What is Oregon?
The state that has an annual Open Enrollment period where clients can switch like to like or like to lesser every year on their birthday (and 30 days after).
300
What is Gabapentin?
This medication can be used to treat serious health concerns such as diabetic neuropathy, but can also be used to treat harmless concerns like Restless Leg Syndrome.
300
What are Missouri and New Jersey?
These states only offer dental coverage with Aetna. (No vision or hearing)
400
What is UHC, Aetna family, Cigna, Humana.
Carriers that do not follow the 2x2x2 rule (or stricter guidelines).
400
What is a KO?
A client who says "I went to the hospital last year and my doctor said I was in a-fib, but I haven't had any issues since he put me on a pill."
400
What are CT, MA, MN, NY, OH, PA, RI, VT?
These states have no excess charges, important to note when pitching Plan N in these states.
400
What is Memory loss? (Alzheimer's, dementia)
Aricept, Razadyne, and Namenda are declinable drugs for what type of condition?
400
What are narcotics?
Percocet, Hydrocodone, Fentanyl, and Tramadol are all types of what category of declinable drugs?
500
What is Cigna, Mutual of Omaha/GPM?
Carriers that will decline a client who started seeing a psychiatrist monthly a year ago.
500
What is a KO?
A client who is is diabetic and takes 2 meds for his heart, 1 for his diabetes, and 1 for his feet.
500
What are ID, IN, KS, MD, OH, OR, UT?
These states offer combination Cancer, Heart Attack & Stroke policies with Aetna.
500
What is Osteoporosis with fractures, HKO?
A client taking lisinopril, gabapentin, and alendronate has no health concerns except for a fractured wrist last year. This is the UW rule that will tell us she is ____. (HKO/Good to Go)
500
What are blood thinners?
Eliquis, Xarelto, and Warfarin are all this type of drug commonly the cause of a client being HKO?






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